Ho metsa bothata

Bothata ba ho metsa ke maikutlo a hore lijo kapa mokelikeli li khomaretse 'metso kapa nako efe kapa efe pele lijo li kena ka mpeng. Bothata bona bo boetse bo bitsoa dysphagia.

Mokhoa oa ho metsa o kenyelletsa mehato e mengata. Tsena li kenyelletsa:

• Ho hlafuna lijo
• Ho e tsamaisa ka morao molomong
• Ho e tsamaisa tlase 'metso (phala ea lijo)

Ho na le methapo e mengata e thusang mesifa ea molomo, ea 'metso le ea metso ho sebetsa hammoho. Ho metsa ho hongata ho etsahala ntle le hore u tsebe seo u se etsang.

Ho metsa ke ketso e rarahaneng. Metsing e mengata e sebetsa ka mokhoa o leka-lekaneng ho laola hore na mesifa ea molomo, ea 'metso le ea metso e sebetsa' moho joang.

Bothata ba boko kapa methapo bo ka fetola botsitso bona bo botle mesifeng ea molomo le ea 'metso.

• Tšenyo bokong e ka bakoa ke multiple sclerosis, lefu la Parkinson kapa stroke.
• Tšenyo ea methapo e ka bakoa ke likotsi tsa mokokotlo, amyotrophic lateral sclerosis (ALS kapa lefu la Lou Gehrig), kapa myasthenia gravis.

Ho imeloa kelellong kapa matšoenyeho ho ka etsa hore batho ba bang ba utloe ho tiisa molaleng kapa ba utloe eka ho na le ntho e khomarelang 'metso. Boikutlo bona bo bitsoa maikutlo a globus mme ha bo amane le ho ja. Leha ho le joalo, ho kanna ha ba le sesosa se itseng.

Mathata a amanang le 'metso hangata a baka mathata a ho koenya. Tsena li ka kenyelletsa:

• Lesale le sa tloaelehang la lisele tse bonoang moo 'metso le mpa li kopanang teng (le bitsoang lesale la Schatzki).
• Li-spasms tse sa tloaelehang tsa mesifa ea 'metso.
• Kankere ea 'metso.
• Ho hloleha ha mokotla oa mesifa botlaaseng ba setopo ho phomola (Achalasia).
• Ho qhekella ho fokotsang 'metso. Sena se ka bakoa ke mahlaseli a kotsi, lik'hemik'hale, meriana, ho ruruha ho sa foleng, lisosa, tšoaetso, kapa reflux ea 'metso.
• Ho hong ho ile ha khomarela metso, joalo ka sengoathoana sa lijo.
• Scleroderma, lefu leo ​​ho lona sesole sa 'mele se hlaselang' metso ka phoso.
• Lihlahala tse sefubeng tse hatellang 'metso.
• Plummer-Vinson syndrome, lefu le sa tloaelehang leo ho lona marang-rang a mucosal a holang ho buloa ha 'metso.

Ho ka ba teng bohloko ba sefuba, maikutlo a lijo a khomaretseng qoqotho, kapa boima kapa khatello molaleng kapa sefubeng se kaholimo kapa tlase.

Matšoao a mang a kenyeletsa:

• Khohlela kapa ho hema hoo ho mpefalang.
• Ho kgohlola dijo tse so koaloeng.
• Ho heletsa.
• Ho nyekeloa.
• Tatso e bolila molomong.
• Ho thatafalloa ke ho metsa feela lintho tse tiileng (ho kanna ha supa lethopa kapa ho tiea) ho fana ka maikutlo a ho thijoa hoa mmele joalo ka setlamo kapa hlahala.
• Ho thatafalloa ke ho metsa mokelikeli empa e seng lintho tse tiileng (ho ka supa tšenyo ea methapo kapa spasm ea 'metso).

U kanna oa ba le mathata a ho metsa ka ho ja kapa ho noa, kapa feela ka mefuta e itseng ea lijo kapa maro. Matšoao a pele a mathata a ho metsa a ka kenyelletsa bothata ha o ja:

• Lijo tse chesang haholo kapa tse batang haholo
• Li-crackers tse omileng kapa bohobe
• Nama kapa kana

Mofani oa hao oa tlhokomelo ea bophelo o tla odara liteko ho li batla:

• Ho hong ho thibang kapa ho fokotsa mmetso
• Mathata le mesifa
• Liphetoho ka lera la 'metso

Teko e bitsoang endoscopy e holimo (EGD) hangata e etsoa.

• Endoscope ke tube e tenyetsehang e nang le lebone qetellong. E kenngoa ka molomo le ho theoha ka metso ho ea ka mpeng.
• U tla fuoa setulo sa botona 'me u ke ke ua utloa bohloko.

Liteko tse ling li ka kenyelletsa:

• Barium swallow le liteko tse ling tsa ho koenya
• X-ray sefubeng
• Ho lekola pH ea Esophageal (litekanyo tsa asiti ka 'metso)
• Esophageal manometry (mehato ea khatello khatello ea 'metso)
• Molala x-ray

U kanna ua hloka ho etsa liteko tsa mali ho sheba mathata a ka bakang mathata a ho koenya.

Kalafo ea bothata ba hau ba ho metsa e latela sesosa.

Ho bohlokoa ho ithuta ho ja le ho noa ka mokhoa o sireletsehileng. Ho koenya ho sa nepahalang ho ka lebisa ho bipetsang kapa ho hema lijo kapa mokelikeli tseleng ea hau e kholo ea moea. Sena se ka lebisa pneumonia.

Ho sebetsana le mathata a ho metsa lapeng:

• Mofani oa hau a ka fana ka maikutlo a liphetoho lijong tsa hau. U ka fumana lijo tse khethehileng tsa mokelikeli ho u thusa hore u lule u phetse hantle.
• U kanna ua hloka ho ithuta mekhoa e mecha ea ho hlafuna le ho koenya.
• Mofani oa hau a ka u joetsa hore u sebelise lintho ho tiisa metsi le maro a mang e le hore u se ke oa li kenya matšoafong a hau.

Meriana e ka sebelisoang e ipapisitse le sesosa, mme e ka kenyelletsa:

• Meriana e meng e khathollang mesifa ea 'metso. Tsena li kenyelletsa nitrate, e leng mofuta oa moriana o sebelisetsoang ho phekola khatello ea mali, le dicyclomine.
• Ho entoa ha chefo ea botulinum.
• Meriana ea ho phekola ho opeloa ke pelo ka lebaka la gastroesophageal reflux (GERD).
• Meriana ea ho alafa lefu la ho tšoenyeha, haeba le teng.

Mekhoa le liopereishene tse ka sebelisoang li kenyelletsa:

• Endoscopy e kaholimo: Mofani oa thepa a ka holisa kapa a holisa sebaka se patisaneng sa 'metso oa hau a sebelisa mokhoa ona. Bakeng sa batho ba bang, sena se hloka ho etsoa hape, 'me ka linako tse ling ho feta hang.
• Mahlaseli a kotsi kapa opereishene: Litlhare tsena li ka sebelisoa haeba mofets'e o baka bothata ba ho koenya. Achalasia kapa spasms ea 'metso le eona e ka arabela ho buuoa kapa liente tsa chefo ea botulinum.

U kanna ua hloka tube ea ho fepa haeba:

• Matšoao a hau a matla 'me ha u khone ho ja le ho noa ho lekana.
• U na le mathata ka lebaka la ho bipetsoa kapa serame sa matšoafo.

Phala ea phepo e kenngoa ka kotlolloho ka mpeng ka leboteng la mpeng (G-tube).

Bitsa mofani oa hau haeba mathata a ho metsa a sa ntlafale kamora matsatsi a 'maloa, kapa a tla a ea.

Bitsa mofani oa hau hang-hang haeba:

• U na le feberu kapa phefumoloho e khuts'oane.
• U ntse u theola boima ba 'mele.
• Mathata a hau a ho metsa a ntse a mpefala.
• U khohlela kapa u hlatsa mali.
• U na le asthma e ntseng e mpefala.
• U ikutloa eka u bipetsa nakong ea ha u ja kapa u noa kapa u noa.

Dysphagia; Ho metsa ka sekhahla; Ho bipetsa - lijo; Boikutlo ba Globus

• Khopho

DJ ea sootho, Lefton-Greif MA, Ishman SL. Mathata a ho lakatsa le ho koenya. Ka: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Ho Buuoa Hlooho le Nko. La 6th. Philadelphia, PA: Elsevier Saunders; 2015: khaolo ea 209.

Munter DW. Mekhatlo ea kantle ho naha ea Esophageal. Ka: Roberts JR, Custalow CB, Thomsen TW, li-eds. Mekhoa ea Tleliniking ea Roberts le Hedges ho Meriana ea Tšohanyetso le Tlhokomelo e Ntle. La 7th. Philadelphia, PA: Elsevier; 2019: khaolo ea 39.

Pandolfino JE, Kahrilas PJ. Ts'ebetso ea Esophageal neuromuscular le mathata a motility. Ka: Feldman M, Friedman LS, Brandt LJ, bahlophisi. Sleisenger le Fordtran's Mpeng le Mafu a Sebete. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016: khaolo ea 43.